Surgical resection plus radiotherapy reduces radiation dermatitis risk without survival benefit in metastatic breast cancer: a retrospective cohort study

He Mingyuan; Chen Yu; Li Yongxia; Luo Daiqin; Chang Jianying

doi:10.16016/j.2097-0927.202603009

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Surgical resection plus radiotherapy reduces radiation dermatitis risk without survival benefit in metastatic breast cancer: a retrospective cohort study

Monographic Reports | 更新时间：2026-10-01

- Surgical resection plus radiotherapy reduces radiation dermatitis risk without survival benefit in metastatic breast cancer: a retrospective cohort study
- Journal of Army Medical University Vol. 48, Issue 18, Pages: 2539-2548(2026)
- 作者机构：
  
  1.贵州医科大学附属医院肿瘤科，贵州贵阳
  2.贵州医科大学附属肿瘤医院肿瘤科，贵州贵阳
  3.贵州医科大学临床医学院肿瘤学教研室，贵州贵阳
- 作者简介：
  
  Chang Jianying， E-mail： 1534085548@qq.com
- 基金信息：
  
  the Project of Science and Technology Plan of Guizhou Province
- DOI：10.16016/j.2097-0927.202603009
  CLC： R730.55;R737.9;R758.1
- Received：02 March 2026，
  
  Revised：2026-06-12，
  
  Accepted：14 June 2026，
  
  Published：30 September 2026
- 稿件说明：
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何明媛，陈宇，李永霞，等.手术切除联合放疗降低转移性乳腺癌患者放射性皮炎风险尚无生存获益：一项回顾性队列研究［J］.陆军军医大学学报，2026，48（18）：2539-2548.DOI：10.16016/j.2097-0927.202603009.

He M Y，Chen Y，Li Y X，et al.Surgical resection plus radiotherapy reduces radiation dermatitis risk without survival benefit in metastatic breast cancer： a retrospective cohort study［J］.J Army Med Univ，2026，48（18）：2539-2548.DOI：10.16016/j.2097-0927.202603009.
何明媛，陈宇，李永霞，等.手术切除联合放疗降低转移性乳腺癌患者放射性皮炎风险尚无生存获益：一项回顾性队列研究［J］.陆军军医大学学报，2026，48（18）：2539-2548.DOI：10.16016/j.2097-0927.202603009. DOI：

He M Y，Chen Y，Li Y X，et al.Surgical resection plus radiotherapy reduces radiation dermatitis risk without survival benefit in metastatic breast cancer： a retrospective cohort study［J］.J Army Med Univ，2026，48（18）：2539-2548.DOI：10.16016/j.2097-0927.202603009. DOI：

摘要

目的

转移性乳腺癌原发灶的局部干预（手术/放疗）能否改善生存仍存争议，本研究对比手术切除联合放疗（surgical resection and radiotherapy，S+R）及单纯放疗（radiotherapy，R）带来的副作用及预后探索初治转移性乳腺癌（metastatic breast cancer，MBC）患者的生存获益及安全性。

方法

研究采用回顾性队列研究设计方案，分析2010—2025年贵州医科大学附属肿瘤医院肿瘤科89例初治诊断为MBC患者（R组42例， S+R组47例），采用倾向性评分匹配（propensity score matching，PSM，卡钳值=0.2）平衡基线特征，匹配后纳入62例（每组31例）。主要终点事件为总生存期（overall survival， OS）、无进展生存期（progression free survival， PFS）；次要终点事件为毒副反应、局部控制（local control，LC）、疾病进展时间（time to disease progression，TTP）。分析患者生存预后指标：OS、PFS、TTP及毒副反应指标：放射性皮肤纤维化、放射性皮炎及患肢淋巴水肿发生率。

结果

匹配后2组基线特征均衡（均

0.05）。随访时间的中位数为56.2个月，S+R组与R组OS的中位数（55.4个月

56.2个月，

=0.738）、PFS的中位数（49.2个月

37.0个月，

=0.959）、TTP的中位数（49.2个月

37.5个月，

=0.808）均无统计学差异，2组患者LC率均为100%。单因素及多因素Cox回归分析显示三阴性分子亚型是OS的独立危险因素（

=15.451，95%

：1.253~190.579，

=0.033）；cN分期是PFS的独立危险因素（

=1.489，95%

：1.006~2.202，

=0.046）。安全性方面S+R组Ⅲ度放射性皮炎发生率显著低于R组（0

12.9%，

=0.001），S+R组对比R组放射性皮肤纤维化发生率（3.23%

9.68%）、患肢淋巴水肿发生率（12.90%

6.45%）均无统计学差异（

0.05）。

结论

与单纯放疗相比，手术切除联合放疗并未显著改善MBC患者的生存结局，但术后患者放射性皮炎风险显著降低；三阴性亚型及cN分期是MBC预后差的重要因素。

Abstract

Objective

The role of local interventions (surgery/radiotherapy) targeting the primary tumor in improving survival among patients with metastatic breast cancer (MBC) remains controversial. This retrospective cohort study compared two local treatment modalities—surgical resection combined with radiotherapy (S+R) versus radiotherapy alone (R)—in terms of toxicities and prognosis in treatment-naive MBC patients

to evaluate the survival benefit and safety profile of these approaches for primary tumor management in MBC.

Methods

Using a retrospective cohort design

we analyzed 89 de novo MBC patients treated at Department of Oncology

Affiliated Tumor Hospital of Guizhou Medical University

between 2010 and 2025 (42 cases in the R group and 47 cases in the S+R group). Propensity score matching (PSM) with a caliper value of 0.2 was employed to balance baseline characteristics

yielding 62 matched patients (31 per group). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Secondary endpoints included treatment-related adverse events (toxicity)

local control (LC)

and time to disease progression (TTP). Statistical analyses were performed to evaluate survival outcomes (OS

PFS

TTP) and toxicity indicators (radiation-induced skin fibrosis

radiation dermatitis

and ipsilateral limb lymphedema).

Results

Baseline characteristics were well balanced after matching (all

0.05). The median follow-up was 56.2 months. No significant differences were observed between the S+R and R groups in median OS (55.4

56.2 month

=0.738)

PFS (49.2

37.0 months

=0.959)

or TTP (49.2

37.5 months

=0.808). No local recurrence occurred in either group (LC: 100%

100%). Univariate and multivariate Cox regression analyses identified the triple-negative subtype as an independent risk factor for OS (

=15.451

95%

:1.253 to 190.579

=0.033)

and cN stage as an independent risk factor for PFS (

=1.489

95%

:1.006 to 2.202

=0.046). For safety outcomes

compared with R

S+R yielded a significantly lower rate of grade 3 dermatitis (0

12.9%

=0.001)

with comparable rates of fibrosis (3.23%

9.68%) and lymphedema of the affected limb (12.90%

6.45%) (both

0.05).

Conclusion

Compared with R

S+R does not significantly improve survival outcomes in MBC patients

but it is associated with lower risk for radiation dermatitis. Triple-negative subtype and cN stage are identified as important adverse prognostic factors in MBC.

关键词

Keywords

references

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